Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cystostomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources
PubMed1997

[Ectopic intraspinal extradural anaplastic ependymoma in an infant].

BACKGROUND: Ependymomas represent about 10% of the spinal tumors in children. Some of them may be unusually located. CASE REPORT: A 10-month-old boy was admitted for an abdominal mass syndrome with dehydration asthenia and acute bladder dysfunction. A few hours later, he developed a flaccid paraplegia. Ultrasonic and magnetic resonance spinal imaging showed a giant intraspinal tumor extending from T9 to IA level, posteriorly located to the dural compartment, widening the spinal cord. Ultrasonography also showed right ureterohydronephrosis due to the neurological bladder dysfunction. A conservative laminotomy-laminoplasty was performed in emergency. Total removal of the tumor that was attached to the right dorsal root was achieved extradurally, requiring resection of the proximal part of the root. Histological features were typical of malignant ependymoma. Chemotherapy was initiated 2 weeks later. The severe renal destruction and the persistent bladder dysfunction led to a heminephrectomy and a cystostomy, 3 weeks later. The neurological recovery was only partial with a follow-up of 18 months. CONCLUSION: Ectopic intraspinal extradural localization of ependymomas is rare and their development from a nerve root is exceptional.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

Colovesical fistula an unusual complication of cytotoxic therapy in a case of non-Hodgkin's lymphoma.

A 65-year old man, a known case of non-Hodgkin's lymphoma of base of the tongue and epiglottis presented with complaints of pneumaturia and faecaluria. He had received the first cycle of cytotoxic therapy (CHOP-regimen). At the end of the cycle he developed febrile neutropenia (circulating granulocyte count <1500/mm3). Cystogram showed air in the bladder area and a fistulous communication to a cavity behind the bladder. CT-scan showed air in the bladder, a fistulous communication between the sigmoid colon and bladder along with an intervening small abscess cavity. On exploration a fistulous communication between the sigmoid and bladder along with an intervening small abscess cavity was found. Resection of involved portion of sigmoid and end to end anastomosis along with a diverting colostomy was done. The bladder was closed in two layers with an omental interposition between it and the sigmoid along with a suprapubic cystostomy. The histopathology demonstrated only inflammatory response without any evidence of malignancy or diverticular disease.

Aged↗
PubMed2002

Case report: an unusual intravesical foreign body: cause of recurrent urinary tract infections.

A 16-year-old boy presented with recurrent urinary tract infections in spite of antibiotic treatment. Investigations revealed the presence of an unusual intravesical foreign body i.e. a common ballpoint. It was removed via cystostomy. In any patient presenting with recurrent urinary tract infections the possibility of an intravesical foreign body should always be considered.

Adolescent↗
PubMed2003

Case report: Malignant phyllodes tumor of prostate.

Malignant phyllodes tumor of prostate is described in a 78 year old man. He had symptoms of prostatism since six months before developing acute urinary retention, which was relieved by suprapubic cystostomy. Transabdominal ultrasonography showed a few hypoechoic areas in a 120 gm prostate. Serum prostate specific antigen was 2.7 ng/ml. Transrectal trucut biopsy was inconclusive. With a diagnosis of benign hyperplasia of prostate. Transvesical prostatectomy was performed. Postoperative biopsy showed phyllodes tumor of the prostate with metastastic deposits in the anterior abdominal wall. He received chemotherapy with Vincristine, Mitomycin C, Adriamycin and Cisplatin every 21st day for six cycles in addition to orchiectomy. Routine follow up by transabdominal ultrasound at ten months showed space occupying lesions in the liver. Patient succumbed to his disease a few days later.

Aged↗
PubMed2003

[Stents in urology].

Ureteral stents are employed in the upper and urethral stents in the lower urinary tract for restitution or maintenance of urinary drainage. Placement of ureteral stents is indicated as an adjuvant measure prior to extracorporal disintegration (ESWL) of large kidney stones to insure urinary drainage and enhance expulsion of fragments and disintegrate. Also, obstruction by very small urinary tract stones that are not treatable by ESWL because they cannot be localized can be relieved by placement of a double-J-stent with immediate elimination of colic. If the cause of urinary tract obstruction is external ureteral compression (retroperitoneal mass), placement of a special tumor stent is one possibility. This, however, has the danger of becoming reobstructed with detritus and blockage of the drainage holes in the stent. In these cases the essential drainage along the stent is blocked by the mass. Therefore, a percutaneous nephrostomy providing direct drainage is easier to control and preferable. Obstructive pyelonephritis is an absolute indication for drainage of the upper urinary tract with a double-J-stent, or even better by percutaneous nephrostomy. If pyeloureteral or ureteral stenoses of the upper urinary tract are opened endoscopically, then the double-J-stent serves to maintain and insure drainage until the new lumen is reepithelialized. In patients with prostatic hyperplasia who no longer respond to medical treatment and who are not candidates for more invasive surgical treatment, a stent can be placed in the prostatic urethra under local anesthesia as a last resort. This procedure is seldom used but, in view of the satisfactory long-term results, it provides a true alternative to bladder drainage by transurethral catheter or percutaneous cystostomy. The same stents may be used in the bulbar urethra to reduce restricture rates following endoscopic treatment of strictures.

Drainage↗
PubMed2001

A large bullet in the bladder.

All manner of foreign bodies have been extracted from the bladder. Introduction into the bladder may be through self-insertion, iatrogenic means or migration from adjacent organs. Extraction should be tailored according to the nature of the foreign body and should minimise bladder and urethral trauma. We report a case of a bullet injury to the bladder, which finally presented as a gross hematuria after remaining asymptomatic for four years. We present here an alternative to suprapubic cystostomy with a large bladder foreign body treated via a combined transurethral unroofing followed by removal using a grasper passed through a suprapubic laparoscopic port.

Adult↗
PubMed1992

Use of penile prostheses to maintain external condom catheter drainage in spinal cord injury patients.

This is a retrospective analysis of 79 spinal cord injury patients who have had penile implants from one to 14 years. The primary indication for implants was the loss of condom catheter with a small retractile penis. Mean period after injury to when the implants were placed was 8.24 years (range 1-21 years). Mean total length of time the implants have been followed was 7.08 years (1-14 years). Sixty patients responded to our detailed questionnaire and they have been subjected to further analysis: prior to the implant 46 patients (77%) frequently lost their condoms. Fourteen of the patients (23%) had indwelling catheters, and 3 (5%) had a suprapubic cystostomy since they could not retain an external condom for urinary drainage because of retraction of a small penis. Post implant, 81% of patients had no accidents involving condom loss, while 19% still lost condoms. All indwelling catheters could be removed except for one patient who continued with a suprapubic catheter following transurethral sphincterotomy (TURS) and a penile implant. Sixty-eight percent used the implant for sex and felt their wives were satisfied. Patient satisfaction survey showed a markedly increased self esteem, increased mobility without fear of condom loss, and an improved sex life. Overall, the long term prosthesis failure rate was 8%. The specific infection complication rate was less than 2%. The Flexirod semirigid, hinged prosthesis proved ideal in meeting the requirements for these patients.

Adult↗
PubMed1994

Long term urinary prognosis of cervical cord injury patients.

We made a retrospective comparative study of 88 cervical cord injury patients concerning their long term urological prognosis. In all, 129 urinary complications have occurred in 54 cases (61.4%). The incidence of urinary complications was high in those with higher levels of injury (except C integral of 4 lesions), a complete injury, a younger age of onset and a longer period after injury. Patients who had an indwelling catheter and a suprapubic cystostomy showed a higher rate of urinary complications. Urodynamically, there was no significant difference between the presence and absence of detrusor hyperreflexia. Those with detrusor-sphincter dyssynergia (DSD) also showed no difference compared to those without DSD. For the prevention of urinary complications in cervical cord injury patients, proper urinary management with clean intermittent catheterisation (CIC), or low pressure voiding is necessary in the early period after the onset of the injury.

Adult↗
PubMed1997

Reinnervation of the rectum with a somatic nerve: a canine study.

The purpose of this communication was to evaluate the possibility of rectal stimulation through nerve autografting. Eleven mongrel dogs were studied. The abdomen was opened under anesthesia. The obturator nerve was cut at its entrance into the obturator foramen and was embedded in a tunnel within the musculature of the rectal wall. Six months later, the abdomen was re-opened and bilateral pelvic ganglionectomy was done to denervate the rectum. As the urinary bladder was also denervated subsequent to the pelvic ganglionectomy, cystostomy was performed. Two bipolar electrodes were applied to the obturator nerve. The effects of electrostimulation were evaluated under basic conditions after urecholine and atropine administration and after xylocaine topical application to the obturator nerve. After bilateral pelvic neurectomy, the basic rectal pressure dropped (P < 0.05) and there was no response to urecholine or to atropine injection. Obturator nerve electrostimulation induced evoked potentials within the nerve as well as rectal pressure rise (P < 0.001); the former was abolished with xylocaine topical application to the nerve and the latter with atropine administration. Microscopic examination revealed that the Schwann cells and axons grew in the connective tissue between the rectal muscle bundles. In conclusion, reinnervation of the denervated rectum using a somatic nerve implant is possible. To our knowledge this study is the first to show "smooth' muscle excitability by stimulation of a somatic nerve implant.

Anesthetics, Intravenous↗
PubMed1998

Perirectal graciloplasty: a novel surgical technique for the treatment of the neurogenic rectum and rectal inertia.

A novel technique for evacuation of the denervated rectum was carried out on 11 mongrel dogs (mean weight 15.8 +/- 4.6 kg). The gracilis muscle was mobilized from the thigh, pedicled on its origin from the pubic ramus, and was introduced into the ischiorectal fossa through a para-anal incision. The abdomen was opened and the rectum mobilized and wrapped with the gracilis muscle which was pulled through the ischiorectal fossa into the pelvis. Rectal denervation was induced by bilateral pelvic ganglionectomy; cystostomy was performed owing to the resultant vesical denervation. Two electrodes were sutured to the gracilis muscle and connected to a myostimulator. The effect of electrostimulation of the gracilis muscle on the rectal and rectal neck (anal canal) pressures and on balloon expulsion was determined. Gracilis muscle stimulation with a burst of 30 Hz during 300 msec with a stimulus of 0.5 msec and an intensity just suprathreshold effected a rectal pressure rise (P < 0.001) with no rectal neck pressure change (P > 0.05); balloon expulsion occurred at a mean balloon filling of 14.8 +/- 3.2 mL. Gracilis muscle transposition could be a suitable experimental model for evacuation of the neurogenic rectum. The technique might be considered for the treatment of the neurogenic rectum, or rectal inertia.

Animals↗
PubMed2001

Anterior urethral valve as a cause of end-stage renal disease.

Although posterior urethral valves are predominant as a cause of obstructive uropathy in children, anterior urethral valves may also appear as the underlying etiologic factor in end-stage renal disease that results from obstruction. Two cases are presented of anterior urethral valve patients that were admitted with end-stage renal disease. The first case was successfully treated with diverticulectomy and urethral reconstruction in preparation for renal transplantation. The second case, however, had been on cystostomy drainage for 6 years and also had a contracted bladder. A more extensive lower urinary tract reconstruction was delayed. Children with poor stream and recurrent infections should be evaluated carefully and anterior urethral valve or diverticula should be considered in differential diagnosis of obstructive lesions.

Adolescent↗
PubMed1996

Posterior urethral injuries in children.

OBJECTIVE: To review the results of the operative treatment of posterior urethral injuries in children. PATIENTS AND METHODS: A total of 29 children (25 boys and two girls, age range 3-14 years) with injuries to the posterior urethra were admitted to this department over 14 years. Twenty-three patients presented immediately after trauma and six were referred after unsuccessful attempt(s) at surgical repair. RESULTS: Fourteen patients underwent suprapubic diversion and primary realignment over a catheter. Urethral continuity with normal urinary continence was achieved in seven of these patients. Four patients underwent a re-operation; urethral reconstruction was successful in these patients, but one patient remained incontinent. Primary realignment with anastomosis was performed in nine patients; the results were satisfactory in six. Urethral stricture developed in all of four patients who were managed with a suprapubic cystostomy alone; a staged repair using the transpubic approach was carried out in two of them and one improved. Partial urethral tears in two patients healed with urethral catheterization alone. CONCLUSION: Primary realignment of the urethra with anastomosis and suprapubic diversion resulted in the highest rate of success for normal urethral continuity. Urethral strictures or urinary incontinence were not major problems in this group. Therefore, we recommend this approach for the initial management of urethral injuries in childhood. Transpubic urethroplasties may be reserved for secondary repair.

Accidents, Traffic↗
PubMed1999

The neonatal management and surgical correction of urinary hydrometrocolpos caused by a persistent urogenital sinus.

OBJECTIVE: To define the neonatal management and ultimate surgical correction via the anterior sagittal transanorectal approach (ASTRA) in cases of neonatal urinary hydrometrocolpos associated with a persistent urogenital sinus (UGS). PATIENTS AND METHODS: We report three patients with UGS (with no ambiguous genitalia) and urinary hydrometrocolpos in whom prenatal ultrasonography showed cystic dilatation of the pelvis. Two patients were temporarily treated with intermittent vaginal catheterization and antibiotic prophylaxis, and in one a cystostomy was necessary to temporarily drain the urine. At the age of 6-8 months the patients underwent reconstructive surgery of the UGS via the ASTRA, under a previous protective colostomy. RESULTS: The mean (range) age of the patients at the last follow-up was 18.7 (8-32) months. A good cosmetic result was obtained in all patients. The vagina was dilated briefly with no anaesthesia in each patient. Patients had normal faecal control after the colostomy was closed and none had urinary incontinence. CONCLUSIONS: When possible, intermittent vaginal catheterization permits sufficient temporary drainage of the urinary hydrometrocolpos associated with a persistent UGS. Subsequent ASTRA allows good exposure of the UGS, assuring the preservation of the anorectal innervation and of the sphincteric mechanism.

Colostomy↗
PubMed2001

Effects of tezosentan, a dual endothelin receptor antagonist, on the cardiovascular and renal systems of neonatal piglets.

BACKGROUND/PURPOSE: Endothelin is a potent biological vasoactive mediator in the cardiovascular and renal systems. Little is known of the effects of endothelin antagonism on the developing heart and kidney, and we hope to show that endothelin does have an important role in the cardiovascular and renal systems of the developing neonate. In this study the authors have examined the effects of tezosentan, a nonselective endothelin-A and endothelin-B receptor antagonist designed for parenteral use, on the cardiovascular and renal systems of healthy neonatal piglets. METHODS: Eight, 7- to 10-day old domestic piglets weighing 2.5 to 3.0 kg were anesthetized, intubated, and ventilated with catheters placed into the jugular vein, left ventricle, and femoral artery. Urine output was monitored via a suprapubic cystostomy. After baseline data were obtained the piglets received tezosentan (1 mg/kg/h) for 1 hour. A set of data was collected just before discontinuation of the 1-hour infusion of tezosentan and another set was collected 1 hour after the discontinuation of the drug. Mean arterial pressure (MAP), heart rate (HR), and urine output (UV) were monitored continuously and cardiac index (CI), systemic vascular resistance (SVR), renal blood flow (RBF), and renal vascular resistance (RVR) were calculated from gamma counts obtained from injections of radio-labeled microspheres at end of the different time periods. Glomerular filtration rate (GFR) was obtained by the sodium iothalamate method. Data were averaged and plotted versus time and analyzed statistically by a Student's t test. RESULTS: (P <.05 versus baseline*). In our experimental animals the infusion of tezosentan diminished MAP and SVR from baseline values of 94 +/- 7 mm Hg and 0.14 +/- 0.03 mm Hg/mL/min, respectively to TEZO values of 62 +/- 4* mm Hg and 0.07 +/- 0.02* mm Hg/mL/min. CI increased from 278 +/- 58 to 367 +/- 75* mL/min/kg with tezosentan. There also was a statistically significant increase in RBF from 1.16 +/- 0.38 to 1.86 +/- 0.37* mL/min/kg, an increase in UV from 0.57 +/- 0.24 to 0.64 +/- 0.12* mL/min, a decrease in RVR from 4.60 +/- 1.47 to 2.03 +/- 0.36* mm Hg/mL/min, and no change in the GFR. CONCLUSIONS: The inhibition of endothelin receptors with tezosentan produced a statistically significant effect on the piglet cardiovascular system with a drop in MAP and SVR and an increase in CI and HR. It also produced a statistically significant increase in RBF and UV and a decrease in RVR without affecting GFR. J Pediatr Surg 36:1824-1828.

Animals↗
PubMed2000

Managing traumatic urethral injuries.

Urethral injuries are relatively common in male dogs and cats. Urethral epithelium has impressive regenerative properties, and healing by second intention is effective as long as there is mucosal continuity across the traumatized area. Principles of managing traumatic urethral injuries include an accurate patient assessment, including a determination of the extent of the urethral injury; correction of electrolyte or acid-base disturbances; provision of urinary diversion, particularly with pelvic or perineal urethral defects; drainage of extravasated urine; and selection of a surgical procedure to repair or bypass the injured portion of urethra. Treatment options include temporary urinary diversion through cystostomy or urethral catheterization and second intention healing, permanent bypassing of the traumatized area through urethrostomy proximal to the injury site, and primary repair of transection injuries. The scrotal site is the most frequently used and preferred site for urethrostomy in the male dog to bypass the injured penile urethra. Urethral surgery necessitates care and attentiveness to detail, considering that accurate approximation of urethral mucosa minimizes fibrosis and helps maintain an adequate luminal diameter. Avoidance of stricture and preservation of function are goals of managing traumatic urethral injuries.

Animals↗
PubMed2005

Efficacy of a navigation system in neuro-endoscopic surgery.

OBJECTIVE: Neuro-endoscopy is playing a greater role in the diagnosis and treatment of several types of lesions, especially in the ventricular system. However, surgical planning and intraoperative orientation during endoscopic surgery are sometimes difficult. The efficacy of a neurosurgical navigation system using three-dimensional computer graphics of magnetic resonance (MR) images in neuro-endoscopic surgery was evaluated in this study. METHODS: We have developed a navigational endoscopic system designed to monitor the tip and direction of the endoscope, with the mirror marker of the navigation connected to a rigid endoscope. Eight patients, 3 cases of aqueductal stenting for isolated fourth ventricle, 3 cases of cystostomy for ependymal cyst, 1 case of septostomy for isolated lateral ventricle, and 1 case of ventricular tap in narrow ventricles, underwent endoscopic surgery using the present system. RESULTS: All patients underwent successful procedures with good outcomes. The present system was very useful in the cases of an accurate ventricular tap in narrow ventricles, identification of anatomic structures, and determining the appropriate route to the target point. CONCLUSIONS: This navigational endoscopic system improved the safety and accuracy of neuro-endoscopic surgery.

Adolescent↗
PubMed1995

[Bladder dysfunctions in encephalomyelitis disseminata--drug and interventional therapeutic options].

Patients with disseminated encephalomyelitis have various urological presentations, ranging from pollakisuria to urge incontinence. After detailed evaluation (neuro-urological examination, urodynamic investigation) drug therapy and various interventional methods must be adapted to the individual manifestations. Patients with detrusor hyperreflexia are treated with oral anticholinergic agents (oxybutynin, trospium chloride, propiverine). Patients with urinary retention are recommended to be managed with clean intermittent (self)-catheterisation. The various interventional therapeutic options (bladder denervation, electrostimulation, local treatment with botulinum toxin) and the surgical therapy (sacral deafferentation and anterior root stimulation, bladder neck closure and cystostomy, sphincterotomy or augmentation cystoplasty) must be reserved for special cases.

Cholinergic Antagonists↗
PubMed1999

Application of new electrosurgical devices and probes in endoscopic neurosurgery.

Complex demands and new indications in neurosurgery have led to the need for new electrosurgical generators (ESUs). For the first time, newly developed, automatically controlled ESUs make it possible to use extremely small and flexible instruments safely and to achieve reproducible microcuts and microcoagulations. These specifications make them suitable for neuroendoscopic interventions. In a series of more than one hundred patients with different intracranial and intraspinal pathologies the new electrosurgical devices and probes were used not only for coagulation but also for cutting. The main indications were endoscopic ventriculo-cisternostomy, ventriculo-cystostomy, and membranectomy. The electrosurgical generators as well as the bipolar microcoagulation and -cutting probes proved to be safe and effective for neuroendoscopic interventions.

Electrocoagulation↗